Tamper-resistant narcotic formulations are just as effective

HONOLULU (Reuters Health) – New formulations of narcotics that resist efforts to snort or inject them are just as effective as their traditional versions, a new literature review found.

“Hopefully, current and future research will reveal a significant reduction in abuse with abuse-deterrent formulations,” Dr. Todd Sitzman, who directs Advanced Pain Therapy, PLLC, in Hattiesburg, Mississippi, and who was not involved in the study, told Reuters Health by email.

In the meantime, Dr. Sitzman says, the new findings show “that abuse-deterrent and non-abuse deterrent prescription opioids are equally safe and effective for their intended purpose.”

The research was presented May 18th at the annual meeting of the American Pain Society in Honolulu, Hawaii.

Dr. Edward Michna, an anesthesiologist at Brigham and Women’s Hospital in Boston who led the study, compared regular and tamper-resistant formulations of 12 common long- and short-acting narcotics for treating non-cancer pain.

His team had reviewed nearly 100 papers and abstracts on oxycodone, fentanyl, morphine, tramadol, methadone, oxymorphone, hydrocodone, codeine, and combinations with oxycodone and codeine.

They found that both the regular and tamper-resistant formulations beat placebos in clinical trials.

The difference in mean change of pain intensity relative to placebo (using the Visual Analogue Scale 100mm, the Numerical Rating Scale 11, the Patient Rating Scale 3 or the Brief Pain Index 10) was always less than zero for abuse-deterrent formulations (ADFs) and non-ADFs, they found.

Safety profiles were similar and the most common adverse events were gastrointestinal disorders, at 10% for tamper-resistant drugs and 12% for regular; nervous system disorders at 9% for tamper-resistant and 11% for regular, skin disorders at 6% for tamper-resistant and 7% for regular drugs.

But while they may be equally effective, tamper-resistant drugs should not supplant regular drugs as the go-to prescription of choice, Dr. Michna said.

He added, “Tamper-resistant formulations address niche problems. They come at a high cost that at this time does not warrant their universal use. It would be useful if these formulations become universal but not at huge cost premium.”